Healthcare Provider Details

I. General information

NPI: 1982223186
Provider Name (Legal Business Name): NIVHAN ARUMUGASAMY MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2020
Last Update Date: 09/05/2023
Certification Date: 09/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1086 N MONROE ST
MONROE MI
48162-3193
US

IV. Provider business mailing address

100 MADISON AVE
TOLEDO OH
43604-1516
US

V. Phone/Fax

Practice location:
  • Phone: 734-244-5380
  • Fax: 734-244-5795
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.148245
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301510360
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: